
<style>
.val{
margin:0px 0px 0px 150px;
color:#000000;
}
.error{
color:#000000;
}

a.link_white{
color:#ccc;
}
a.link_white:hover{
color:#000000;
}

</style>
<div class="left_konten">
	<div class="breadcumbs"><?php echo $cumb;?></div>
	<div class="detail_product">
		<div class="order_content">                   
			<h2>Payment Confirmation / Konfirmasi Pembayaran</h2>
			<?php echo $this->session->flashdata('message_succes_conf');?>
					<form action="" method="post" onsubmit="return check();">
						<div class="form_row">
						<?php echo form_error('order_code', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Order Code :</strong></label>
						<input type="text" class="contact_input" name="order_code" value="<?php echo set_value('order_code'); ?>">
						</div> 
						
						<div class="form_row">
						<?php echo form_error('nama', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Nama :</strong></label>
						<input type="text" class="contact_input" name="nama" value="<?php echo set_value('nama'); ?>">
						</div> 
						
						
						<div class="form_row">
						<?php echo form_error('tgl_byr', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Tanggal Bayar :</strong></label>
						<?php echo dateDropdown('tgl_byr',FALSE,'2000',getTh('plus',1))?>
						</div>
						
						
						<div class="form_row">
						<?php echo form_error('rek_asal', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>No Rek Asal :</strong></label>
						<input type="text" class="contact_input" name="rek_asal" value="<?php echo set_value('rek_asal'); ?>">
						</div> 

						<div class="form_row">
						<?php echo form_error('bank_asal', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Nama Bank Asal :</strong></label>
						<input type="text" class="contact_input" name="bank_asal" value="<?php echo set_value('bank_asal'); ?>">
						</div>

						<div class="form_row">
						<?php echo form_error('bank_id', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Bank Tujuan :</strong></label>
						<?php echo dropDownBank(set_value('bank_id'))?>
						</div> 
						
						<div class="form_row">
						<?php echo form_error('jml_uang', '<div class="error">', '</div>'); ?>
						<label class="contact"><strong>Jumlah Uang :</strong></label>
						<input type="text" class="contact_input" name="jml_uang" value="<?php echo set_value('jml_uang'); ?>">
						</div> 

						

						
						<table width="100%" border="0" cellspacing="0" cellpadding="0" class="">
						<tbody>
						<tr>
						<td width="48%">&nbsp;</td>
						<td> <input type="submit" class="" value="Submit" /></td>
						</tr>
						</tbody>
						</table>
						</form>     
			</div>

		<div class="clear"></div>

	</div>
</div>


